WALGREEN CO (NPI# 1811902109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811902109 |
| Entity Type | Organization |
| Organization Name | WALGREEN CO |
| Other Organization Name | WALGREENS #09133 |
| Practice Address |
1314 N West Ave Jackson MI 49202-2051 |
| Mailing Address |
1901 E Voorhees St Mailstop #790 Danville IL 61834-4509 |
| Practice Telephone | 5177831676 |
| Mailing Telephone | 2177092386 |
| Mailing Fax Number | 2177092344 |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2015-12-30 |
| Authorized Official Name | MR. ALAN T NIELSEN (TREASURER) |
| Authorized Official Telephone | 8473153523 |
| Is Organization Subpart | Y |
| Parent Organization Name | WALGREENS BOOTS ALLIANCE INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 5301007975 | MI | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4809115 DME | 05 | |
| MI | 2366208 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2366208 | 01 |
| Other Name | Type Code |
|---|---|
| WALGREENS #09133 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306459615 | Walgreen Co | Pharmacy | 23335 Soboba Rd, San Jacinto, CA 92583 | 2020-08-26 |
| 1548873284 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 909 Veterans Blvd, Del Rio, TX 78840-4065 | 2020-08-24 |
| 1013527092 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 433 W Van Buren St Ste 150, Chicago, IL 60607-0433 | 2020-08-05 |
| 1801419650 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1301 N Main St Ste 100rx, Blacksburg, VA 24060-3129 | 2020-05-27 |
| 1699398602 | Walgreen Co | Pharmacy | 262 Danny Thomas Pl Ste 100rx, Memphis, TN 38105-3678 | 2020-05-26 |
| 1861021495 | Walgreen Co | Pharmacy | 1870 W Rio Salado Pkwy Ste 100rx, Tempe, AZ 85281-2695 | 2020-04-06 |
| 1154960722 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 41840 W Maricopa- Casa Grande Hwy, Maricopa, AZ 85138 | 2019-12-31 |
| 1932746047 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 300 W Broughton St, Savannah, GA 31401-3216 | 2019-12-09 |
| 1053955377 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1530 Celebration Blvd Ste 100rx, Kissimmee, FL 34747-5164 | 2019-10-30 |
| 1528600269 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 212a Moore Rd, King, NC 27021-8703 | 2019-10-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | WALGREEN CO. | 161 Washington Street, Suite 1400, Conshohocken, PA 19428 |
| Iowa Business Entities | WALGREEN CO. | 300 Wilmot Road, Deerfield, IL 60015 |
| Virginia Business Entities | WALGREEN CO. | 161 Washington St Ste 1400, Conshohocken, Pennsylvania 19428-2055 |
| Washington State Corporations | WALGREEN CO. | 300 Wilmot Rd, Deerfield, IL 60015-4614 |
| North Carolina Corporations | Walgreen Co. | 2626 Glenwood Avenue, Suite 550, Raleigh, NC 27608 |
| Oregon Corporations, Companies and Business Names | WALGREEN CO. | 300 Wilmot Road, Deerfield, IL 60015 |
| New York State Corporations | WALGREEN CO. | 80 State Street, Albany, New York 12207-2543 |
| Oklahoma Business Registrations | WALGREEN CO. | Attention Tax Department, 200 Wilmot Road, Deerfield, IL 60015 |
| Street Address |
1314 N WEST AVE |
| City | JACKSON |
| State | MI |
| Zip Code | 49202-2051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760724116 | Priyank Mahesh Trivedi | Pharmacist | 1314 N West Ave, Jackson, MI 49202-2051 | 2013-03-25 |
| 1295002061 | Michael Wortinger | Pharmacist | 1314 N West Ave, Jackson, MI 49202-2051 | 2011-11-22 |
| 1538445879 | Brian Hoffbauer | Pharmacist | 1314 N West Ave, Jackson, MI 49202-2051 | 2011-11-01 |
| 1386928273 | Linda Reddick | Pharmacist | 1314 N West Ave, C/o Walgreens #09133, Jackson, MI 49202-2051 | 2011-10-11 |
| 1780968222 | Sravanti Ambati | Pharmacist | 1314 N West Ave, Jackson, MI 49202-2051 | 2011-10-03 |
| 1942583059 | Amitkumar Kantilal Patel | Pharmacist | 1314 N West Ave, Jackson, MI 49202-2051 | 2011-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821590316 | Leslie Dominique Barroso | Social Worker | 834 Kennedy St, Jackson, MI 49202 | 2018-03-01 |
| 1073011136 | Nicole Szarek | Social Worker | 1200 N. West Ave, Jackson, MI 49202 | 2018-01-24 |
| 1598299430 | Cedric Griffin | Behavior Technician | 950 W. Monroe St, Jackson, MI 49202 | 2017-04-18 |
| 1285081612 | Patricia Decker | Psychologist | 950 West Monroe, Suite 500, Jackson, MI 49202 | 2016-05-16 |
| 1619344314 | Erica Ries | Social Worker | 1200 N West Ave Ste 800, Jackson, MI 49202 | 2015-08-28 |
| 1184007189 | Sarah Johnson | Behavioral Analyst | 818 Winifred St, Jackson, MI 49202 | 2015-07-08 |
| 1871971697 | Scott A Watterson Dds, Pllc | Dentist | 1030 Laurence Ave, Suite 3, Jackson, MI 49202 | 2015-05-13 |
| 1043608680 | Brenda Beverly | Counselor | 1190 West, 1190 West Suite 812, Jackson, MI 49202 | 2015-01-06 |
| 1295091593 | Natalie Ann Kember | Social Worker | 1206 Clinton, Jackson, MI 49202 | 2012-04-11 |
| 1912218728 | Tina Marie Pierce | Respite Care | 225 N Wisner St, Jakson, MI 49202 | 2010-06-25 |
| Find all providers in zip 49202 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1912409475 | Moyes Pharmacy Inc | Pharmacy | 227 S Mulberry St, Jackson, GA 30233-2058 | 2018-03-01 |
| 1619410321 | Red Cap Pharmacy 001 LLC | Pharmacy | 214 N West Ave Ste A, Jackson, MI 49201-1903 | 2016-11-29 |
| 1285050864 | Lewis Family Drug, LLC | Pharmacy | 825 3rd St, Jackson, MN 56143-1187 | 2014-03-06 |
| 1356664239 | Stone Drug | Pharmacy | 830 W Broadway, Jackson, WY 83002-9000 | 2010-03-08 |
| 1215053061 | Country Market Pharmacies, L.L.C. | Pharmacy | 1410 W Ganson St, Jackson, MI 49202-4063 | 2007-03-22 |
| 1851467823 | Costplus Pharmacy | Pharmacy | 104a W University Pkwy, Jackson, TN 38305-1635 | 2006-11-28 |
| 1205909777 | Brookshire Grocery Company | Pharmacy | 2861 Terry Rd, Attention Pharmacy Dept, Jackson, MS 39212-3051 | 2006-11-15 |
| 1396818860 | Brookshire Grocery Company | Pharmacy | 5841 Ridgewood Rd, Attention Pharmacy Dept, Jackson, MS 39211-2618 | 2006-11-15 |
| 1861564486 | Brents Drugs of Belhaven | Pharmacy | 902b E Fortification St, Jackson, MS 39202 | 2006-11-15 |
| Find all providers in JACKSON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.